Clinical Overview

What Is Fibromyalgia?

Fibromyalgia is a long-term condition with widespread pain and fatigue, and it can also bring headaches, non-refreshing sleep, and mood changes. It affects about 2 in 100 people. It is real, though it can be hard to diagnose.

How It's Diagnosed

There is no single lab test. A provider diagnoses fibromyalgia from a person's symptoms and history using recognized criteria. People often see several doctors before they get answers.

How It's Managed

Guidelines suggest starting with non-drug steps — education, guided exercise, and therapies like CBT — then adding individualized medicine if needed. Care works best when it fits the person, and a provider guides the plan.

Where Compounding Fits In

When a provider prescribes it, a compounding pharmacy can prepare custom forms and strengths — like capsules, topical creams, or dye-free versions — for patients who need an alternative. Mixwell prepares these only by prescription and makes no recommendation about therapy.

Built for Quality

Mixwell is a state-licensed, non-sterile compounding pharmacy in Chino, CA — serving Chino Hills, Ontario, Pomona, Diamond Bar, and Rancho Cucamonga, and delivering across California. We prepare formulas in a USP <795>/<800>-compliant lab. We do not make sterile products or injectables.

Talk With Your Provider

Ask a licensed provider about a plan that fits you. If a custom formulation is prescribed, call Mixwell at (909) 378-7301 to speak with our pharmacist.

References

Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2017;76(2):318–328. doi:10.1136/annrheumdis-2016-209724.
Wolfe F, Clauw DJ, Fitzcharles MA, et al. 2016 Revisions to the 2010/2011 fibromyalgia diagnostic criteria. Semin Arthritis Rheum. 2016;46(3):319–329.

Commonly used Compounding Solutions

Ketoprofen-Cyclobenzaprine-Lidocaine Customized Topical Gel

Target Localized Relief

This multi-ingredient topical gel targets muscle and joint discomfort directly at the site of application.

Triple-Action Discomfort Support

The formulation combines three active ingredients that work through different pathways to interrupt localized discomfort:

Ketoprofen: A non-steroidal anti-inflammatory drug (NSAID) that targets localized swelling and tissue irritation.
Cyclobenzaprine: A muscle relaxant that helps ease localized muscle tightness and tension.
Lidocaine: A local anesthetic that temporarily numbs nerve signals in the application area for fast-acting surface relief.

The Transdermal Gel Advantage

By utilizing high-quality PCCA transdermal vehicles, the active ingredients are safely carried through the outer skin barrier. This allows for deep, localized absorption directly into the affected muscles and joints while minimizing systemic uptake throughout the body.

Technical Specifications →

Low-Dose Naltrexone (LDN) Capsules

What Is Low-Dose Naltrexone?

Naltrexone is an FDA-approved drug at 50 mg. "Low-dose naltrexone" (LDN) means much smaller doses, usually about 1.5 to 4.5 mg. These low strengths are not sold commercially, so they are compounded by prescription for one patient.

How It's Thought to Work

Researchers propose that a brief block of opioid receptors may raise the body's own endorphins, and that LDN may have anti-inflammatory effects. These mechanisms are still being studied.

What Is It Used For?

Prescribers use LDN off-label for conditions such as fibromyalgia and chronic pain. The evidence is still limited and early, and larger studies are underway. Whether LDN is appropriate is the prescriber's decision.

Is It FDA-Approved at This Dose?

No. Naltrexone is FDA-approved at 50 mg, not at low doses. LDN use is off-label. This is a compounded preparation.

Key Safety Note

People taking opioid pain medicine should not take naltrexone, please consult with your doctor. The prescriber reviews all medicines and decides what is safe.

Quality

Made only by prescription in Mixwell's USP <795>- and <800>-compliant lab. Mixwell is a non-sterile pharmacy and does not make injectables. Not FDA-reviewed at this dose. No result is promised, and this is not claimed to be better than commercial products.

References

Younger J, Parkitny L, McLain D. The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain. Clin Rheumatol. 2014;33(4):451–459.
Younger J, Noor N, McCue R, Mackey S. Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels. Arthritis Rheum. 2013;65(2):529–538.

Technical Specifications →